Thalidomide upper limb embryopathy -: pathogenesis, past and present management and future considerations

Thalidomide embryopathy results in various congenital upper limb differences, ranging from complete amelia to radial dysplasia and digital malformations. This review article provides a comprehensive overview including updates about its pathogenesis, a historical account of the management of the paediatric thalidomide patient, experience with management of the adult patient as well as creating awareness about early onset age-related changes associated with limb differences. Despite its withdrawal from the market in November 1961, novel discoveries have meant thalidomide is licensed again and is currently still in use to treat a variety of conditions, including inflammatory disorders and some cancers. Yet, if not used safely thalidomide still has the potential to cause damage to the embryo. Recent work identifying thalidomide analogues that retain clinical benefits yet without the harmful effects are showing great promise.
Understanding the problems thalidomide survivors face as they age can allow
surgeons to support their unique healthcare issues and translate these principles of care to other congenital upper limb differences.